Ischemic wound healing and possible treatments.

The present review describes the major steps in wound healing, the factors that clinically cause ischemia including the changes found in diabetes mellitus and the possible interventions and treatments of ischemic wounds. The number of randomized, double-blind, controlled clinical trials is scarce, especially on the healing of chronic ischemic soft tissue wounds. Experimental and clinical studies to date have demonstrated that hyperbaric oxygen may be an effective treatment of chronic hypoxic wounds and that certain growth factors (e.g., recombinant platelet-derived growth factor-BB) are likely to enhance the healing of such wounds. Other treatments are discussed, among them vasoactive drugs (e.g., pentoxifylline), occlusive dressings and surgical treatment, including delayed primary closure of acute ischemic wounds.